Yan Xing, Liu Changhong
Thoracic Surgery Department, The Second Affiliated Hospital of Dalian Medical University Thoracic surgery, DaLian, China.
Front Surg. 2022 May 16;9:865040. doi: 10.3389/fsurg.2022.865040. eCollection 2022.
Lung cancer is one of the most fatal malignant tumors in the world. Overcoming this disease is difficult due to its late diagnosis and relapse after treatment. Minimal residual disease (MRD) is described as the presence of free circulating tumor cells or other tumor cell derivatives in the biological fluid of patients without any clinical symptoms of cancer and negative imaging examination after the treatment of primary tumors. It has been widely discussed in the medical community as a bridge to solid tumor recurrence. Radiology, serology (carcinoembryonic antigen), and other clinical diagnosis and treatment methods widely used to monitor the progression of disease recurrence have obvious time-limited and -specific defects. Furthermore, as most samples of traditional liquid biopsies come from patients' blood (including plasma and serum), the low concentration of tumor markers in blood samples limits the ability of these liquid biopsies in the early detection of cancer recurrence. The use of non-blood-derived fluid biopsy in monitoring the status of MRD and further improving the postoperative individualized treatment of patients with lung cancer is gradually ushering in the dawn of hope. This paper reviews the progress of several non-blood-derived fluid samples (urine, saliva, sputum, and pleural effusion) in detecting MRD in lung cancer as well as selecting the accurate treatment for it.
肺癌是全球最致命的恶性肿瘤之一。由于其诊断较晚且治疗后易复发,攻克这种疾病颇具难度。微小残留病灶(MRD)被定义为在原发性肿瘤治疗后,患者生物体液中存在游离循环肿瘤细胞或其他肿瘤细胞衍生物,且患者无任何癌症临床症状,影像学检查呈阴性。作为实体瘤复发的一个关联因素,它在医学界已得到广泛讨论。放射学、血清学(癌胚抗原)以及其他广泛用于监测疾病复发进展的临床诊断和治疗方法,存在明显的时间局限性和特异性缺陷。此外,由于传统液体活检的大多数样本来自患者血液(包括血浆和血清),血液样本中肿瘤标志物浓度较低,限制了这些液体活检在癌症复发早期检测中的能力。使用非血液来源的液体活检来监测MRD状态,并进一步改善肺癌患者术后的个体化治疗,正逐渐迎来希望之光。本文综述了几种非血液来源的液体样本(尿液、唾液、痰液和胸腔积液)在检测肺癌MRD以及为其选择精准治疗方面的进展。